Cases with Refractory Ascites and a Delayed Response to Tolvaptan

Intern Med. 2016;55(22):3273-3277. doi: 10.2169/internalmedicine.55.7035. Epub 2016 Nov 15.

Abstract

The patient was a 67-year-old female with liver cirrhosis due to hepatitis C. She was administered furosemide at 20 mg/day and spironolactone at 25 mg/day, but the ascites did not improve. Despite the additional administration of tolvaptan at 3.75 mg/day, the response to ascites was still poor. While the dose of tolvaptan was thereafter increased to 7.5 mg/day on the 7th hospital day, the ascites still persisted. However, she continued to receive tolvaptan (7.5 mg/day) because the worsening of her subjective symptoms was mild and she wished to do so. The ascites was later found to have almost completely disappeared on computed tomography (CT) at 6 months.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antidiuretic Hormone Receptor Antagonists / therapeutic use*
  • Ascites / diagnostic imaging
  • Ascites / drug therapy*
  • Benzazepines / therapeutic use*
  • Diuretics / therapeutic use
  • Drug Administration Schedule
  • Female
  • Furosemide / therapeutic use
  • Hepatitis C / complications
  • Humans
  • Liver Cirrhosis / complications
  • Spironolactone / therapeutic use
  • Tolvaptan
  • Tomography, X-Ray Computed

Substances

  • Antidiuretic Hormone Receptor Antagonists
  • Benzazepines
  • Diuretics
  • Tolvaptan
  • Spironolactone
  • Furosemide